National Provider Identifier Database

BRIDGEWAY HEALTH SERVICES LLC
Mental Health (Including Community Mental Health Center)


Contact Information

BRIDGEWAY HEALTH SERVICES, LLC
1032 S. BRIDGEWAY PL,
STE 110
EAGLE, ID83616
Phone: 208-475-0800
Fax: 208-639-0901
Website:
Specialty Taxonomy Code
* Mental Health (Including Community Mental Health Center) 261QM0801X

* Indicates primary specialty

NPI Profile & details for BRIDGEWAY HEALTH SERVICES, LLC

NPI Number 1265703953
Legal business name
LBN
BRIDGEWAY HEALTH SERVICES, LLC
Authorized official GRANT BELNAP - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 01/26/2012
Last updated 01/26/2012 - About 14 years ago
Sole proprietor1 Not specified
Identifiers
  • ID License #: M7357

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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